The influence of surgical excision margins on keloid prognosis

Kian Tjon Tan, Nigam Shah, Susan A. Pritchard, Duncan Angus McGrouther, Ardeshir Bayat

    Research output: Contribution to journalArticlepeer-review


    Keloid disease is known to have variable clinical behavior in response to therapy and there is no clinicopathologic classification that predicts such varied behavior. The aim of this study was to study the effect of excision margins and other histopathologic characteristics on keloid prognosis.Seventy- five multiethnic patients presenting with keloid scars at a department of plastic and reconstructive surgery during an 11-year period were included in this study. Clinical data was collected and detailed histologic analyses using light microscopy were carried out on archived patient specimens.A detailed histopathologic examination of all tissue samples identified keloid border or margin characteristics which were classified into "circumscribed" (borders clearly-demarcated) and "infiltrative" (borders not clearly-demarcated and not easily-definable). The specific histologic findings were correlated with keloid recurrence which revealed that incomplete peripheral (P <0.001) and deep excision margins (P <0.001), as well as infiltrative borders (P <0.05) were associated with higher 1-year reported recurrence rates.This study has given evidence that incomplete surgical excision are associated with higher recurrence and this may justify the practice of routine histopathologic reporting of keloid excision margins. Copyright © 2009 by Lippincott Williams & Wilkins.
    Original languageEnglish
    Pages (from-to)55-58
    Number of pages3
    JournalAnnals of Plastic Surgery
    Issue number1
    Publication statusPublished - Jan 2010


    • Excision margin
    • Histopathology
    • Keloid
    • Prognosis
    • Recurrence
    • Surgery


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